We propose ultrasound-guided core needle biopsy as a very safe and effective tool in cases of parotid swelling in which fine needle aspiration cytology has failed to give a definitive diagnosis.

The NHS Plan identified the need for changes in consent practice, and led to the issuing of a model consent policy and standard consent forms for use in the NHS. The aim of this study was to determine current consent practices for common rhinology and laryngology procedures. A telephone survey was conducted of 40 otolaryngology Senior House Officers (SHOs) across England and Wales, asking about local consent procedure, and the specific complications discussed before common operations. The responsibility for routine consenting belonged to SHOs in 95 per cent of departments. Model NHS consent forms were used in 72.5 per cent and information sheets given to patients in 25 per cent of departments. The specific operative risks mentioned to patients by the SHOs showed great variability. The provision of standardized consent protocols for each operation, together with information sheets and the model NHS forms, could aid juniors involved in consent and prove beneficial to our patients.

We describe the clinical picture, diagnosis and subsequent management of this patient, and also reproduce the histopathological and radiological images that aided our diagnosis. We also review reported cases of rhabdomyoma of the larynx, including their location, management and outcome.

Vagal nerve stimulation (VNS) is a recognised and effective measure in treating refractory epilepsy and depression. VNS implantation is a widely accepted surgical procedure, most commonly performed by neurosurgeons. Otolaryngologists, in particular those with an interest in head and neck surgery, are very familiar with the surgical anatomy and dissection of the vagus nerve in the carotid sheath. We present a retrospective analysis of the first 12 patients to be implanted in our department. Our series suggests that otolaryngologists can safely and effectively perform VNS implantation. Otolaryngologists can assess and treat the most common post-operative complication of dysphonia and help the neurologist set the correct level of stimulation in such a way as to minimise laryngeal complications.